Gender Difference in Failure Patterns for Hip Resurfacing

Femoral remnants from females have lower likelihood of fracture, presence of osteonecrosis

MONDAY, Nov. 7 (HealthDay News) -- Gender differences exist in the failure patterns of metal-on-metal hip resurfacing arthroplasty, according to a study published online Oct. 13 in BMC Medicine.

Andrea Hinsch, from the University Medical Center Hamburg-Eppendorf in Germany, and colleagues investigated the potential influence of gender on morphological failure patterns following aseptic failure of hip resurfacing arthroplasty. The cause of failure in femoral remnants from 173 hips from patients of known gender was compared with 31 failures from patients of unknown gender. Gender differences in the risk of periprosthetic fractures, osteonecrosis, the presence of excessive intraosseous lymphocyte infiltration, and interface hyperosteoidosis were analyzed using adjusted and unadjusted logistic regression analyses.

The investigators found that, after adjusting for gender, age, size of the femoral component, and preoperative clinical diagnosis, the likelihood of fracture and presence of osteonecrosis in femoral remnants from female patients were lower (adjusted odds ratio [aOR], 0.29 and 0.16, respectively; P = 0.02 and 0.01, respectively). However, the likelihood of excessive intraosseous lymphocyte infiltration and interface hyperosteoidosis were higher (aOR, 10.22 and 4.19, respectively; P = 0.08 and 0.03, respectively).

"We demonstrated substantial sex differences in distinct failure patterns of metal-on-metal hip resurfacing. Recognition of pathogenically distinct failure modes will enable further stratification of risk factors for certain failure mechanisms and thus affect future therapeutic options for selected patient groups," the authors write.

The study was funded by Biomet Inc., Corin Group PLC, DePuy Orthopaedics Inc., Zimmer Inc., and Smith & Nephew.

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